2021 AQI69: Intraoperative Antibiotic Redosing

Measure Description

Percentage of patients, aged 18 years and older, who received preoperative antibiotic prophylaxis within 60 minutes prior to incision (if fluoroquinolone or vancomycin, two hours) and undergo a procedure greater than two hours duration who received intraoperative antibiotic redosing at a maximum interval of two half-lives of the selected prophylactic antibiotic.

Denominator

All patients, aged 18 years and older, who received preoperative antibiotic prophylaxis within 60 minutes prior to incision and undergo a procedure greater than two hours duration

Denominator Definition: For the purpose of this measure, preoperative antibiotic prophylaxis includes prophylaxis with the following antimicrobial agents:

• Ampicillin-sulbactam
• Ampicillin
• Aztreonam
• Cefazolin
• Cefuroxime
• Cefotaxime
• Cefoxitin
• Cefotetan
• Clindamycin
• Piperacillin-tazobactam

Denominator Criteria (Eligible Cases):
All patients, aged 18 years and older
AND
Patient received antibiotic prophylaxis within 60 minutes (if fluoroquinolone or vancomycin, two
hours) prior to incision: 10A87
AND
Procedure >2 hours duration: 11A60
AND
Patient encounter during the reporting period (CPT):
00100, 00102, 00103, 00120, 00124, 00126, 00140, 00144, 00145, 00147, 00160, 00162, 00164, 00170, 00172, 00174, 00176, 00190, 00192, 00210, 00211, 00212, 00214, 00215, 00216, 00218, 00220, 00222, 00300, 00320, 00322, 00350, 00352, 00400, 00402, 00404, 00406, 00410, 00450, 00454, 00470, 00472, 00474, 00500, 00528, 00529, 00534, 00537, 00539, 00540, 00541, 00542, 00546, 00548, 00550, 00560, 00562, 00563, 00566, 00567, 00580, 00600, 00604, 00620, 00625, 00626, 00630, 00632, 00635, 00640, 00670, 00700, 00730, 00750, 00752, 00754, 00756, 00770, 00790, 00792, 00794, 00796, 00797, 00800, 00802, 00811, 00820, 00830, 00832, 00840, 00842, 00844, 00846, 00848, 00851, 00860, 00862, 00864, 00865, 00866, 00868, 00870, 00872, 00873, 00880, 00882, 00902, 00904, 00906, 00908, 00910, 00912, 00914, 00916, 00918, 00920, 00921, 00922, 00924, 00926, 00928, 00930, 00932, 00934, 00936, 00938, 00940, 00942, 00944, 00948, 00950, 00952, 01120, 01140, 01150, 01160, 01170, 01173, 01200, 01202, 01210, 01212, 01214, 01215, 01220, 01230, 01232, 01234, 01250, 01260, 01270, 01272, 01274, 01320, 01340, 01360, 01382, 01390, 01392, 01400, 01402, 01404, 01430, 01432, 01440, 01442, 01444, 01464, 01470, 01472, 01474, 01480, 01482, 01484, 01486, 01500, 01502, 01520, 01522, 01610, 01620, 01622, 01630, 01634, 01636, 01638, 01650, 01652, 01654, 01656, 01670, 01710, 01712, 01714, 01716, 01732, 01740, 01742, 01744, 01756, 01758, 01760, 01770, 01772, 01780, 01782, 01810, 01829, 01830, 01832, 01840, 01842, 01844, 01850, 01852, 01920, 01924, 01925, 01926, 01930, 01931, 01932, 01933, 01935, 01936, 01951, 01952, 01961, 01962, 01963, 01965, 01966.
Denominator Exclusions

• Acute Renal failure24: 11A61
• Chronic kidney disease25: 11A62
• Procedure duration <2 half-lives of selected prophylactic antibiotic: 11A63

Numerator

Patients who received intraoperative redosing of prophylactic antibiotics at a maximum interval of two halflives of the selected prophylactic antibiotic

Numerator Note: If multiple redosing windows pass during a procedure, the recommended redosing window is the maximum amount of time that can pass between any two doses in order to meet this measure. Information on dosing and redosing should reflect clinical practice guidelines, local hospital policy, manufacturer guidance, and other materials imperative to safe practice. Antibiotic redosing should occur prior to closing the surgical incision. Maximum redosing intervals for included antibiotics are listed below:

• Ampicillin-sulbactam: 2 hours
• Ampicillin: 2 hours
• Aztreonam: 4 hours
• Cefazolin: 4 hours
• Cefuroxime: 4 hours
• Cefotaxime: 3 hours
• Cefoxitin: 2 hours
• Cefotetan: 6 hours
• Clindamycin: 6 hours
• Piperacillin-tazobactam: 2 hours

Numerator Quality-Data Coding Options for Reporting Satisfactorily
Performance Met:
11A64 Patient received intraoperative redosing of prophylactic antibiotics at a maximum interval of two half-lives of the selected antibiotic
OR
Performance Met
11A65 Patient received intraoperative redosing of prophylactic antibiotics according to facility antibiotic stewardship program.
OR
Performance Not Met:
11A66 Patient did not receive intraoperative redosing of prophylactic antibiotics at a maximum interval of two half-lives of the selected antibiotic or according to facility antibiotic stewardship program.

Numerator Exclusions

None

NQF ID Number

N/A

NQS Domain

Patient Safety

High Priority Measure

Yes

Includes Telehealth?

No

Inverse Measure

No

Proportional Measure

Yes

Continuous Variable Measure

No

Ratio Measure

No

Number of performance rates to be calculated and submitted

1

Risk-Adjusted Status?

No